Duration: Included as part of/ not necessarily consecutive with chemistry rotation/ elective available
Rotation Director(s): Saad Ghosn, MD
Description of Rotation
The diagnostic immunology residency training rotation involves learning the methodologic principles as well as the clinical interpretation of test results utilizing the following techniques: direct and indirect immunofluorescence, serum and urine protein electrophoresis, immunofixation and various serologic procedures including precipitation, immunodiffusion, agglutination, passive agglutination, hemagglutination inhibition, nephelometry, enzyme-linked immunosorbent assay and complement fixation. In addition, the resident is expected to acquire a basic knowledge of the immune system and its response to antigen. In addition to the evaluations of the humoral immune response described above, the in vitro and in vivo evaluations of cellular immune functions will be reviewed. Immunophenotypic analysis of cells of the immune system will be covered in detail during the flow cytometry rotation during hemepath.
- Know the principles of antigen-antibody precipitation and agglutination reactions as they relate to serologic testing, and nephelometry.
- Know the principles of enzyme-linked immunosorbent assays as they relate to viral antibody testing.
- Know the principles of direct and indirect immunofluorescent assays as they relate to autoantibody and infection disease testing.
- Know specific sample requirement for each assay performed in the lab unit.
- Understand the clinical application of each test result and the limits of result interpretation.
- Know how to interpret serum, CSF and urine electrophoresis results. Know the principles of in vivo and in vitro cell immune assays and their clinical applications.
- Know the basis for molecular genetics evaluation of lymphomas and leukemias.
The resident will rotate at all appropriate lab benches at the VAH performing immunology tests under the direction of Dr. Ghosn, and will observe and perform all tests. The resident will interpret all serum and urine protein electrophoresis and immunofixation results. The resident will participate in problem resolution, especially in clinical matters. The resident will function whenever appropriate as an interface with the laboratory staff and clinical services. The resident will investigate unusual and/or interesting immunology results by reviewing patient’s chart and/or communicating with the clinician. The resident will communicate the clinical correlation informally with laboratory staff and rotation director(s).
Additionally, the resident will prepare and present a 30-minute lecture to the laboratory staff on a topic mutually agreed upon by the rotation director(s) and the resident. This lecture will be given during the last month of the rotation. In addition, the resident will participate with the rotation directors in an informal conference on a topic concerning clinical utilization of the lab data.
The resident and the lead technologists will arrange the schedule so that the resident can spend some time every day at the bench. The resident will perform and/or watch all serological procedures including serologic testing for syphilis and hepatitis. He/she will perform and/or watch the set-up and identify the patterns of ANA tests. He/she will perform and/or watch other immunofluorescent tests. The resident will interpret all serum, CSF and urine protein electrophoresis as well as immunofixation results.
- Daily attendance and performance at the bench as assessed by technologist and rotation directors.
- Attendance and performance at discussion sessions with rotation directors.
- Written and practical examination administered by directors at the end of the rotation.